Myringotomy is a surgical treatment for middle ear infections. A surgeon makes a small cut in the eardrum to let fluid drain and relieve pressure. They may insert a small tube to allow continued drainage and prevent the wound from closing.
Myringotomy with tubes — also called myringotomy with tympanostomy — is a common procedure in children.
School-aged children will likely be able to return to school the day after surgery. A child may need ear drops afterward. Some bleeding or discharge may occur but should stop after a few days.
This article explains what to expect during a myringotomy and throughout the recovery period.
According to a 2023 review, myringotomy with tubes is one of the
The review’s authors note older research that estimates 7% of children in the United States will have tubes in their ears by the time they reach 3 years of age.
During a myringotomy, an ear, nose, and throat (ENT) surgeon makes a tiny hole in the eardrum.
Sometimes, the ENT surgeon will use a suction device to remove fluids that have built up. If the mucus is too thick, they may flush the space with salt water.
Who might need one
It may also help those who have had three or more infections in 6 months or four in 12 months that a doctor has treated with antibiotics.
Doctors might recommend it for children with a high risk of speech or language delays where there is a fluid buildup in one or both ears that is unlikely to disappear within 3 months.
Children who have a high risk of developing ear infections may include those with the following conditions:
Doctors might also recommend myringotomy for people who have other conditions that may cause a fluid buildup, including:
- eardrum anomalies
- Down syndrome
- a cleft palate
- middle ear injury due to air pressure changes, also called barotrauma
The procedure may help in the following ways:
- making future ear infections less likely
- reversing hearing loss due to a fluid buildup in the middle ear
- addressing issues with speech, balance, behavior, and sleep
- improving engagement at school
- decreasing the use of oral antibiotics
A myringotomy very often involves tubes. Without tubes, the hole an ENT creates during myringotomy would close in several days, which would prevent fluid from draining.
However, a 2020 randomized study of 74 children in Oman that followed them for 2 years after a myringotomy with or without tubes found no significant differences in hearing test results 9 months after surgery.
According to the authors of the study, children with a tube showed a higher risk of complications, such as fluid leakage from the ear and eardrum scarring.
People can often return home on the day of the procedure once they have recovered from anesthesia. This usually takes 1–2 hours.
The procedure rarely causes pain, but an individual may feel several symptoms afterward due to the anesthesia, including:
Surgery should immediately resolve hearing loss due to a fluid buildup in the middle ear.
An ENT specialist will schedule follow-up appointments to measure the person’s hearing and check their progress. They may prescribe a few days of antibiotic ear drops
The United Kingdom’s National Health Service (NHS) recommends protecting the ear during contact with soapy water after surgery, such as during shampooing. They recommend using a piece of cotton wool covered with petroleum jelly.
However, evidence suggests there are no benefits to stopping water from entering the ear. No current U.S. guidelines recommend this unless a doctor instructs a person to use ear plugs, water-tight devices, or headbands during swimming.
People can leave the hospital on the day of surgery.
After this, recovery may progress as follows:
- Some bleeding or discharge may occur but should stop after 3–4 days.
- Hearing should immediately improve and continue to get better. According to a
2015 study, it should progressively improve from 2–10 weeks after the operation.
- Children who were experiencing issues with speech, balance, language, or learning before surgery may find these symptoms take longer to resolve than hearing. Recovery may take weeks or months. Some of these issues may also be related to other factors, which the procedure alone may not treat.
- The tubes may remain in the eardrum for months to years, depending on the design and where the surgeon places them on the eardrum. In the U.S., most tubes stay in for 12–14 months.
An ENT specialist will monitor and support a person’s recovery through regular ear examinations, hearing tests, and consultations.
Complications can occur after myringotomy. These
- fluid leakage
- blockage of the tube
- further infections
- a tear or hole remaining in the eardrum after the tube falls out
- movement of the tube into the middle ear in rare cases
- the tube falling out too early
- the tube staying in for too long
Scarring may also develop in the middle ear or eardrum. This is common and typically does not have functional significance or require further surgery.
Other complications, such as eardrum tears or a displaced tube, may require another operation.
- a body temperature of at least 102.2°F (39°C)
- fluid or pus coming from one or both ears
- worsening symptoms, such as ear pain, or symptoms that last more than 2–3 days
- muffled or lost hearing
A general practitioner can make a referral to a specialist in ENT health for a more detailed investigation. An ENT consultation might be necessary for a person with the following health problems:
- repeated, severe ear infections
- ear infections that do not respond to antibiotics
- hearing loss linked to middle ear fluid
- an anatomic anomaly that prevents proper drainage of the middle ear
The following are answers to some common questions people ask about myringotomy and ear tubes.
How long is hearing muffled after myringotomy?
Hearing should immediately get better after surgery.
What precautions should people take after myringotomy?
Antibiotic ear drops
What is a common complication of myringotomy?
Myringotomy involves making a tiny slit in the eardrum to treat chronic middle ear infections and other health problems that affect fluid drainage from the ear. The surgeon often inserts a small tube to allow fluids to drain without the hole closing up.
Myringotomies are most common in young children, but adults and older children may also need them. An individual may need 24–48 hours off from school or work to recover after this single-day procedure. Antibiotic ear drops may reduce the risk of ear leakage, the most common complication after surgery.